HAS-BLED is a scoring system developed to assess 1-year risk of major bleeding in patients taking anticoagulants with atrial fibrillation.
Major bleeding is defined as being intracranial bleedings, hospitalization, hemoglobin decrease > 2 g/dL, and/or transfusion.
Condition Points:
H Hypertension: (uncontrolled, >160 mmHg systolic) 1
A Abnormal renal function: Dialysis, transplant, Cr >2.26 mg/dL
Abnormal liver function: Cirrhosis or Bilirubin >2x Normal or AST/ALT/AP >3x Normal 1
S Stroke: Prior history of stroke 1
B Bleeding: Prior Major Bleeding or Predisposition to Bleeding 1
L Labile INR: (Unstable/high INR), Time in Therapeutic Range < 60% 1
E Elderly: Age > 65 years 1
D Prior Alcohol or Drug Usage History (≥ 8 drinks/week)
Medication Usage Predisposing to Bleeding: (Antiplatelet agents, NSAIDs)
A calculated HAS-BLED score is between 0 and 9 and based on seven parameters with a weighted value of 0-2.
The HAS-BLED mnemonic stands for:
Hypertension
Abnormal renal and liver function
Stroke
Bleeding
Labile INR
Elderly
Drugs or alcohol
Guidelines on atrial fibrillation care recommend assessment of bleeding risk in AF using the HAS-BLED bleeding risk.
A score of ≥3 indicates high risk.